MEDICAL ASSESSMENT FORM For Students with Permanent Disabilities - Nova Scotia
Instructions for Completing
MEDICAL ASSESSMENT FORM
For Students with Permanent Disabilities
Nova Scotia Student Assistance requires this form to be completed by a qualified medical assessor in order to verify
the applicant’s permanent disability and to determine eligibility for disability-related financial grants and disability training
related goods and services, while attending post-secondary education. Individuals who meet the disability criteria
become part of the Department of Advanced Education Labour Market Agreement for Persons with Disabilities
(LMAPD) program administered through the Post-Secondary Disability Services Division.
“Permanent disability” means a functional limitation caused by a physical or mental impairment that restricts the ability
of a person to perform the daily activities necessary to participate in studies at a post-secondary school level or the
labour force and is expected to remain with the person for the person’s expected life.
Note: Not all medical conditions are considered permanent disabilities for the purposes of these grants.
Complete the Consent Form on page 1, Section A and Section B on page 2.
Have the sections relating to your disability completed by the appropriate qualified medical assessor. For
example, if you are visually impaired, your form should be completed by an Ophthalmologist or Optometrist. If
you have a hearing impairment, your form should be completed by an Audiologist. Your limitations and barriers
to your program of study must be clearly identified.
If you have a Learning Disability, you must attach a current Psycho-Educational Assessment, completed
within the last 5 years by a Registered Psychologist and submit it with the signed Consent Form (page 1) and
completed Section A and B (page 2). Any other supporting documentation in reference to your learning needs
would also be helpful.
If you have ADD/ADHD, the medical documentation must include a comprehensive report that includes the
following information: diagnosis according to the DSM IV Criteria, year of diagnosis, in-depth background
history, diagnostic tools used including information from collateral informants used for diagnostic purposes,
evidence of impairment affecting various environments, medication used and recommendations for
overcoming limitations/barriers. Any other supporting documentation in reference to your learning needs along
with copies of any previous Psycho-Educational Assessments would be beneficial.
If you previously did not meet the disability criteria either because your documentation was not current or there
was insufficient information provided to support your application, you must provide additional or current
information from your medical assessor that clearly outlines the limitations and barriers that your disability will
present while participating in studies at a post-secondary institution. Any previous documentation sent to our
office is on file.
This Medical Assessment Form will be used as one of the criteria to determine this student’s eligibility to receive
Federal and/or Provincial grant funding. Please ensure the diagnosis represents this student’s permanent disability and
identifies the disability-related educational barrier(s).
Please complete the appropriate section(s) pertaining to the permanent disability diagnosis and return the form
to the student.
Medical assessors must complete all parts of Section K on pages 6 and 7, clearly describing the disability-
related educational barriers and recommended interventions.
Completed Forms are to be mailed to: Nova Scotia Student Assistance
PO Box 2290, Halifax Central
Halifax, NS B3J 3C8
Telephone: 424-8420 Toll Free in Canada 1-800-565-8420
Your student loan application will not be processed until all documentation has been received.
All information must be received no later than two months before your period of study ends. Funds cannot be
released after your period of study end date.
MEDICAL ASSESSMENT FORM For Students with Permanent Disabilities - Nova Scotia PDF
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